Abstract：
BACKGROUND: Percutaneous coronary intervention (PCI) remains a major therapeutic tool in the management of acute coronary syndromes (ACS). However, it is not widely practiced in sub-Saharan Africa, particularly for the management of ACS. The availability of a catheterization laboratory for 24-hour management of ACS in Dakar is an important step in improving the prognosis of patients. The objective of our study was to evaluate the clinical and prognostic profile of patients presenting an ACS and treated by PCI.
METHODS: This is a retrospective study that included all patients who underwent PCI for ACS at hospital principal Dakar during the period from January 2019 to December 2020.
RESULTS: Our study included 112 patients with a mean age of 60 years (extremes 31-96 years) and a male predominance (sex ratio 4.09). Cardiovascular risk factors were dominated by hypertension (47.3%) and smoking (39.3%). Chest pain was present in 97% of patients. Left ventricular systolic function was impaired in 56 patients with a mean of 50% and extremes of 20 and 78%. Thrombolysis with streptokinase was used in 13 patients with STEMI. The majority of coronary angiogram (95%) were performed between 8 am and 5 pm. The radial route was the most commonly used (85.7%). Double vessel coronary artery disease was predominant (39,3%) and the left anterior descending artery was the most affected (60.7%). The PCI was performed in all patients and in more than half of the cases (55%) within 12 hours of delay. The PCI success rate was 96.4%. Sixty-seven patients (59.8%) underwent balloon predilation. PCI was performed with a drug-eluting stent in the majority of patients (92.8%). The outcome was favorable in 96.4% of the patients, but there were 3 deaths (2.7%).
CONCLUSIONS: Treatment of ACS by PCI is a reality in Senegal with a considerable success rate. However, intervention delays remain one of the major challenges of this management.
METHODS: This is a retrospective study that included all patients who underwent PCI for ACS at hospital principal Dakar during the period from January 2019 to December 2020.
RESULTS: Our study included 112 patients with a mean age of 60 years (extremes 31-96 years) and a male predominance (sex ratio 4.09). Cardiovascular risk factors were dominated by hypertension (47.3%) and smoking (39.3%). Chest pain was present in 97% of patients. Left ventricular systolic function was impaired in 56 patients with a mean of 50% and extremes of 20 and 78%. Thrombolysis with streptokinase was used in 13 patients with STEMI. The majority of coronary angiogram (95%) were performed between 8 am and 5 pm. The radial route was the most commonly used (85.7%). Double vessel coronary artery disease was predominant (39,3%) and the left anterior descending artery was the most affected (60.7%). The PCI was performed in all patients and in more than half of the cases (55%) within 12 hours of delay. The PCI success rate was 96.4%. Sixty-seven patients (59.8%) underwent balloon predilation. PCI was performed with a drug-eluting stent in the majority of patients (92.8%). The outcome was favorable in 96.4% of the patients, but there were 3 deaths (2.7%).
CONCLUSIONS: Treatment of ACS by PCI is a reality in Senegal with a considerable success rate. However, intervention delays remain one of the major challenges of this management.
摘要：
背景：经皮冠状动脉介入治疗（PCI）仍然是急性冠状动脉综合征（ACS）的主要治疗工具。然而,它在撒哈拉以南非洲并不广泛使用，特别是ACS的管理。达喀尔24小时管理ACS的导管实验室的可用性是改善患者预后的重要一步。我们研究的目的是评估接受PCI治疗的ACS患者的临床和预后情况。
方法：这是一项回顾性研究，包括2019年1月至2020年12月期间在达喀尔主要医院接受ACSPCI的所有患者。
结果：我们的研究包括112名患者，平均年龄为60岁（极端年龄为31-96岁），男性占主导地位（性别比为4.09）。心血管危险因素主要为高血压(47.3%)和吸烟(39.3%)。97%的患者出现胸痛。56例患者的左心室收缩功能受损，平均为50％，极端为20％和78％。13例STEMI患者采用链激酶溶栓治疗。大多数冠状动脉造影（95％）在上午8点至下午5点之间进行。径向路径是最常用的(85.7%)。双血管冠状动脉疾病占主导地位（39,3％），左前降支受影响最大（60.7％）。所有患者和超过一半的病例（55％）在延迟12小时内进行了PCI。PCI成功率为96.4%。67例患者（59.8％）接受了球囊预扩张术。大多数患者（92.8％）使用药物洗脱支架进行PCI。结果在96.4％的患者中是有利的，但有3人死亡(2.7%)。
结论：在塞内加尔，PCI治疗ACS已成为现实，成功率相当高。然而,干预延迟仍然是这种管理的主要挑战之一。
方法：这是一项回顾性研究，包括2019年1月至2020年12月期间在达喀尔主要医院接受ACSPCI的所有患者。
结果：我们的研究包括112名患者，平均年龄为60岁（极端年龄为31-96岁），男性占主导地位（性别比为4.09）。心血管危险因素主要为高血压(47.3%)和吸烟(39.3%)。97%的患者出现胸痛。56例患者的左心室收缩功能受损，平均为50％，极端为20％和78％。13例STEMI患者采用链激酶溶栓治疗。大多数冠状动脉造影（95％）在上午8点至下午5点之间进行。径向路径是最常用的(85.7%)。双血管冠状动脉疾病占主导地位（39,3％），左前降支受影响最大（60.7％）。所有患者和超过一半的病例（55％）在延迟12小时内进行了PCI。PCI成功率为96.4%。67例患者（59.8％）接受了球囊预扩张术。大多数患者（92.8％）使用药物洗脱支架进行PCI。结果在96.4％的患者中是有利的，但有3人死亡(2.7%)。
结论：在塞内加尔，PCI治疗ACS已成为现实，成功率相当高。然而,干预延迟仍然是这种管理的主要挑战之一。
